Home Forums Discussions General Discussion Interpretation of lab results from quest

I am meeting with a quest lab rep tomorrow, but am very interested in having patients with an updox portal viewing lab result have the capability to scroll their mouse cursor on each result with a brief description of each particular lab. This will, I think help reduce questions and help educate patients. Maybe this capability is already available, but currentiy I have my patients log onto quest web site and after multiple clicks find the spot where the labs are discussed, not very user friendly or efficient. Any thoughts???

http://mygazelleapp.com/tour/

This link helps if one has a smart phone, but if I find out something for a desktop will let every one know.

That may be tough. When you print the result from Quest (to send to the portal) it just prints as a PDF file. There are some explanations.. normal ranges, and references for some of the more obscure tests... but nothing to explain what, say, a creatinine of 1.5 might mean. the PDF is in no way interactive.

We get surprisingly few requests for clarification. When I send to the portal I have a template that I use. Mine does not say much, but you could sure make up a brief description of each test for yours. My partner has one that says something like "we will be glad to respond to brief questions by reply as time permits, but for significant issues you may be asked to make an appointment." It just does not come up often for me.

We send a short note to the patient which is also printed on the last page of the labs (assuming you downloaded the results through the interface). It gives basic interpretations and instructions like "Your labs show low vitamin d. You should take X IU of vitamen d daily and return in 6 months. Your labs have no other significant abnormalities. If you wish to discuess them in more detail, please schedule an appointment."

Its the incessant-- what is MPV, MCHC MPV questions that drive me crazy and if a short concise description when the cursor is placed over the lab result would be the best option if available-

oh, well Alice is perfectly willing to discuss that with them Jimmie. All they have to do is schedule an appointment for a Lab Review. Then she will go over all of that. But she won't go over all of that by phone or email. It must be, and they are told, a Lab Review Office Visit.

Wayne,

You city guys are tough

I may just have to resort to that as well--

Jimmie,its funny that on this issue I dont' think we are. We give them a written response which mentions anything the doctor thinks is significant on their lab results, along with actual instructions and they did not have to come in and/or pay a copay/deductible. And we don't get our fee. Now, sometimes they need to come in regardless, as when the HA1C is 8.5. Then the instructions include coming in for an office visit. Sometimes its come back in 6 months for retesting to see if action is required. But, if they don't want to take her word for it and want a more detailed and involved, well that is not something that can be effectively done over the phone in a reasonable period of time. So they need to come in for an office visit where we set aside proper time to have a short discussion about it. No, she cannot call them at the end of the day...she needs to go home too. I really don't think we're being hard-nosed about it. Though admittedly, some patients disagree.

Wayne,

I think you are being more than fair and not hard nosed at all. Sometimes, the written word is hard to convey the humor intended.
Just from a medical legal perspective, it is better to have a face to face.
No argument at all from me. I just got home from the office just a few minutes ago myself and it is about 9pm mountain time, so I concur.

Of course if we could bill for the information we give on the phone, like lawyers do, then we might feel differently.

Wayne,

Sometimes more info leads to more questions, and this whole idea may in fact create more potential for e-message or non face to face questions, and my intention is to reduce not increase this behavior.
However, I think the best solution will be to create a private form on Updox and define all the common parameters of a CBC, BCS12, lipid, and TSH and on my Updox face page direct patients to this form if they have questions about the interested lab otherwise make an appointment or figure out a portal directed consult charge for answering further questions.

For most of my patients I try to have them come in before their visit to have labs done and then at their visit we can review the results. Much more rewarding than trying to explain later.
Does not work for all labs as some need to be obtained urgently at a visit but getting them before as much as possible helps.

Greg

Well, if you give too much information, that can happen. We seem to have a pretty good balance. Few people ask for more information, and most who do were already told to come in on letter! They just want to ask the questions on the phone instead.

Greg,

I can see you have been on AC since 2005, and just since starting AC last November, it has been much easier to coordinate labs before visits to minimize all the questions (since my nurse does all the scheduling she can manage everything from her desktop)--however about 10% or so fall through the cracks or just can't make it a day or two before because with the geographic outlay of Montana I have patients not bat an eye and drive 120 miles one way to come to see me, and prefer to do labs at the office. So even as I get my practice more organized and efficient there will continue to remain a certain percentage that will have lab questions to address after the visit--so I just have to get a bit creative and may have to utilize the portal a bit more to my advantage/patients advantage-hopefully.

My partner and I are of two minds; I like the idea of getting the labs ahead of time, accepting that there often will be additional labs that become necessary after the visit. She feels that is a total waste of effort, and never gets labs ahead. We get about the same number of requests for clarification, she maybe a bit more than me (but that may reflect differences in our patient population.) She uses the template on UpDox that advises that significant requests for clarification will either require an appointment or will get a $25 charge (not billable to insurance). She gets few takers. I don't address either option, and my patients don't seem to ask much. The few that do are the really anxious folks who are best managed by short and frequent appointments anyway.